之前的骨折和随后的骨折风险:对FRAX进行更新的元分析
J A Kanis1,2, H Johansson3,4, E V McCloskey5,6
1Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@sheffield.ac.uk.
概括
之前的骨折显著增加了未来骨折的风险,无论骨矿物质密度 (BMD). 这一发现基于一项大型国际研究,对于改善骨折预测和预防策略至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 流行病学 流行病学
- 老年学是指老年学的学科.
背景情况:
- 以前的骨折史是随后骨折的已知风险因素.
- 在国际上量化这种风险对于像FRAX这样的临床风险评估工具至关重要.
研究的目的:
- 在国际基础上量化与先前骨折相关的骨折风险.
- 探索年龄,性别,基线以来的时间和骨矿物质密度 (BMD) 如何影响这种风险.
主要方法:
- 来自32个国家的64个队列的初级数据的元分析,其中包括超过200万个人.
- 利用扩展的Poisson模型来检查先前骨折史与各种骨折结果之间的关联.
- 结合结果使用加权β系数,根据年龄,性别,骨质量和随访时间进行调整.
主要成果:
- 以前的骨折史显著增加了任何临床骨折 (HR=1.88),骨质疏松性骨折 (HR=1.87),严重骨质疏松性骨折 (HR=1.83),部骨折 (HR=1.82) 的风险.
- 增加的风险在男性和女性中是相似的,并且仅在考虑BMD时略有降低.
- 低BMD解释了少量过度风险,强调了先前骨折史的独立贡献.
结论:
- 之前的骨折史使未来骨折风险大幅增加,独立于BMD.
- 这种风险在不同性别之间是一致的,并在国际上得到了量化.
- 准确的量化能够改善骨折预防的病例发现策略.
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